Translator: Rhonda Jacobs
Reviewer: Peter van de Ven Good morning and thank you. It's an honor and privilege to be here. I feel very lucky to be
one of those invited to do so. So, I'll begin. First of all, if you came here
to hear about the Fast Five movie, or you're Vin Diesel fans, (Laughter) you got the wrong ticket. (Laughter) Okay. So, we're kind of doing a bit
of time traveling this morning, so let's do this again. Imagine you're 100 years old, celebrating your 100th birthday. Imagine what that feels like, what you look like, and what you're doing. Now, imagine that you're celebrating
your birthday on water skis. The water's skidding underneath your skis,
you approach your dock, you wave to your kids, your grandkids,
your great-grandkids, maybe some great-great-grandkids
and their friends, who wave back to you. And then you cut wide
and you splash them all with water. (Laughter) Now, is that sort of vitality a dream or can it be reality? Well, let's look. This is a cartoon, a sketch,
based on an MRI image.

It shows what it looks like
to slice through the thighs of a 40-year-old athlete. The red's muscle, the yellow's fat
and the white's bone. So there's lots of muscle,
pretty thick bone and just a rim of fat. Now, this is a similar image
of a slice through the legs of a 74-year-old sedentary male. With muscle withering away
like that in the 70s, is the kind of energy and strength
you need to water ski at 100 even possible? Well, let's look at what stands
in the way of getting to 100. The top ten killers: heart disease, cancer, lung disease, stroke, accidents, Alzheimer's, diabetes, kidney disease, lung infections and suicide. Those are some pretty big
horsemen of the apocalypse that we have to get by. So what can we do? When I was at NIH,
I had put on 20 extra pounds, and that was since leaving
the Navy and the Marine Corps, and I didn't consider that to be a threat, because it wasn't one of those ten
that I just listed, and I was just overweight,
not even obese. But I also knew what to do to cure that: eat less, exercise more.

And I was eating a good diet, I was eating something similar to this. You may recognize it — this is the current recommendations
of the United States government, and — what they call healthy. And this is similar to what I was eating. And you may not recognize
that there's a lot of industrial influence that goes into these recommendations. Harvard took a look at this and said,
"We can do better than that," and so they made some changes.

And they called it "Healthy Plate"
instead of "My Plate." And so they said, more vegetables,
less fruit, cut out dairy, there's some people
who can't even eat dairy, and whatever's in dairy
we can get somewhere else, so it doesn't have to be
a recommendation, that's just the influence
of the dairy industry.

And they also brought healthy oils
and staying active up onto the front page instead of burying it in the fine print. And the MyPlate recommendations, even after decades of epidemic obesity, didn't even include the advice
to eat less until 2010. (Laughter) Again, that's industrial influence — they want you to eat healthy
or don't eat healthy; as long as you eat, they're happy. So it's eat, eat, eat. Now, at NIH, my day was sandwiched
between my childcare drop-off and pick-up. So to try to get more work done,
I started skipping lunch. One of those days,
I also skipped breakfast, which, at the time,
felt a little bit sinful. And that shows you how strong
the dogma is about breakfast. But that "breakfast is the most
important meal of the day" thing, that's advertising, not science.

So anyway, I skipped breakfast, and I noticed that I was
less hungry during the day than I'd been when I ate breakfast. So I sinned again, I tried it again, and again, and again, and kept it up,
and after a few days of that noticed that that 20 pounds of flab
I was carrying felt a little thinner. So I checked on the scale,
and sure enough, my weight had dropped. So I kept it up —
week after week for 20 weeks, my weight was dropping
by a pound per week. And the key here is appetite. My appetite had dropped. I wasn't trying to eat less at this time. My appetite had dropped,
so I was eating less and feeling full, having eaten less food. Sounded great to me. And so that was my way
of getting rid of that extra 20 pounds. Fast forward to 2005. My wife tried the same thing — what I called it then was a study of one,
I tried it on myself.

My wife tried it on herself. She had the same result —
the same kind of study of one. In 2005, we wondered, can we share this?
Can this work for other people? But there was a problem —
calories in, calories out. Timing wasn't supposed
to make a difference. We're physicians,
we know this stuff, right? Why would timing matter? We had no good explanation for that. So I dove into the scientific
literature trying to find out, trying to solve this little mystery. And looking through stuff
that dated back to the 1930s, I started seeing how much influence industry had had on our perceptions
about diet and eating, and that's where
I learned about things like "breakfast is the most
important meal of the day." But I also learned that
the solution to the timing question was a fairly obvious thing; it was based on stuff I'd learned
the first year of medical school and was too boring
to be thinking about later. So, I put the pieces together,
put them in a book, and my wife and I founded
this company called Fast-5 to try to encourage other people
to try to give this tool a try.

So we printed this book,
and it comes down to five — one rule, five words: Eat within five consecutive hours. So what's the rest of the book about? It's talking about,
explaining how it actually works. (Laughter) But it does come down
to that one rule: five hours. And that five hours can be
at any time during the day — meaning it can be
an evening window of five hours, a morning window of five hours, doesn't matter. And what you choose to eat
during that window is also up to the individual. It can be MyPlate;
it can be Healthy Plate; it can be vegetarian;
it can be kosher; it can be halal — whatever a person chooses to eat
can fit within the Fast-5 program. It is the timing
that makes the difference. For some people, Fast-5
is like Cinderella's slipper — they're overweight, they've been overweight
for as long as they can remember — obese. They try it on, it fits perfectly,
and their whole life changes.

And because of that, with us just
having a website and very little else — a bunch of e-mails
back and forth to people, Fast-5 has spread
to those six continents. Seven if you count penguins. (Laughter) But penguins fast
for three months at a time, and so I think they're taking it
a little too far. (Laughter) So, translated
into the various languages by people who wanted to share
this idea that worked for them, in their own language,
with their own countrymen. And there are Facebook groups,
Yahoo groups with over 3,000 members. So people are out there sharing it,
sharing what works for them. This is one tool in the arsenal
that people can try and see if it works for them.

That's why I call it the study of one. You don't have to ask
somebody else if it's healthy, you can find out for yourself. Does it work for you or doesn't it? That's what the study of one is about. So — this is how you can
get started on a study of one — and this doesn't have to be about Fast-5. A study of one can approach
any question that you have. Is this healthy for me or not? And what I've learned from e-mailing
all these people about Fast-5 is that people often don't trust
their own sense of what's good for them, they need it to come from outside.

And I'm saying you can trust yourself; you can trust your body —
it's good at this. And this is the way you can get started: You take measurements —
the first three you can do at home, the last two are lab tests. And there may be others
that your doctor would recommend based on whatever change you're making
and you want to give it a try. Now, I ask for
a little bit of common sense — you don't want a pulse of zero.

(Laughter) You don't want a blood pressure of zero. But within the range of common sense, all these numbers
are the lower, the better. So it's fairly simple
to navigate with these: the lower, the better. And HbA1c is a measure
of the average blood glucose over the last couple of months. So it just gives an average measurement
to let you know where you've been. hs-CRP is a measure of the amount
of the amount of inflammation that's going on anywhere in the body. Inflammation is our body's primary tool
for treating anything — it's its only tool. It just throws inflammation
at anything that goes wrong. So if anything is going wrong,
inflammation goes up; and if everything's quiet
and good, it goes down. And you may be wondering
where cholesterol is on this. Cholesterol has 11 subtypes and lots of different risk factors
that have to be integrated, so it doesn't make
for an easy choice or an easy guide.

The study of one is like
navigating the old fashioned way: You check your position,
you set your course, you travel it for a while, and then you stop and you check again, and if things are looking good,
you keep going the same way, and if they're not looking good, you change course
and do something differently. Now, two or three months is a long time. It'd be nice to have a GPS
where you eat a candy bar and it says, "Oh, you're going downhill." (Laughter) And then it says, "Make a U-turn." And then you eat a salad,
and it says, "Recalculating." (Laughter) Well, we don't have that yet …

Maybe. For right now,
we just have the study of one. But what the study of one does is tell you what's healthy for you
with your activity, your choices, your diet, your stress level,
your environment and your genes. It doesn't say what's healthy
for some lab rat or some person who's in a paid study
in an ivory tower somewhere; it's what matters for you. In addition to those
tests and measurements, I also say, "How do you feel?" Because your body has a network
of monitors called nerves that you can count on
to tell you what's going on, but they don't print out numbers,
so you have to record, maybe assign it a scale of one to ten
to say, "How are you feeling? How are your aches and pains? Are you feeling
energetic and sharp or not?" And with those, you can guide yourself
on what's healthy for you.

Now, there's another mystery about Fast-5, and that is: how do animals
control their level of fat? Not too little, not too much. It'd be nice if it
were happening for humans too. They have some fat for reserve, but you never see animals
just eating and eating until they blow up like puffer fish. (Laughter) Fast-5 seems to turn on
the same mechanism for humans: to get just the right amount of appetite
to keep the fat in balance — not too much, not too little. We still do not know how that works. But I trust that it does. And if you would like to try Fast-5,
you can see if it works for you too.

Now, let's go back to the athlete. Lots of muscle, right? This isn't the 40-year-old. This is a 70-year-old. Let's look at all three for comparison. On top: 40-year-old. Middle: 74-year-old sedentary. On the bottom:
70-year-old and very active. This is why the fact that muscle
is use it or lose it, is why there's more to diet
than just food. And this doesn't stop at muscle cells. Use it or lose it applies to brain cells. And it applies to the body as a whole. Whether we're used and active
and important to our community — that matters. And so my idea of a healthy plate
looks something like this: You say, "Well, where are the veggies?" (Laughter) They're some little dot
in this physical part, so small you can't even see it, because there's activity,
there's things like not smoking, alcohol in moderation
that goes into physical.

But there's the whole
other world of social activity and mental activity that we need a diet of
to keep everything healthy. Our cells go way beyond our skin
in terms of how they communicate. Now, we see this word
every day, probably — probably more than we like to see it, and so I'd like you
to use it as a reminder. Did I enrich today? If you see this word somewhere out there, think: Did I enrich today?
Did I put something new in my life? Did I generously share
some advice or some skills or something with somebody else? It's like biological karma: What you give out comes back to you. Now, imagine you're 100, again. It's your birthday still. The sun's setting,
you're sitting on the dock, life is good. Your knees ache … from skiing. (Laughter) After all, you're not 90 anymore. (Laughter) (Applause) And you think, if one can profit
from their own generosity, what better dividend, what more precious dividend
can there be than health. Thank you very much. (Applause).



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